Categories
Nevin Manimala Statistics

Novel bioengineered collagen with Manuka honey and hydroxyapatite sheet for the treatment of lower extremity chronic wounds in an urban hospital wound care setting

Wounds. 2023 Jan;35(1):E35-E38.

ABSTRACT

INTRODUCTION: A novel BCMH sheet has been shown to achieve improved wound closure rates in chronic and acute wounds when compared with SOC.

OBJECTIVE: This retrospective evaluation assessed chronic wound closure rates with SOC or treatment with the BCMH sheet in an urban hospital wound clinic.

METHODS: Forty-seven chronic wounds were treated with SOC or the BCMH sheet. The primary endpoint was time to closure. For wounds that did not close, investigations were conducted to determine the reason.

RESULTS: Twenty wounds were treated with SOC, which varied in usage of multiple products and/or therapies, and 27 wounds were treated with the BCMH sheet. The average initial wound size was not statistically different between the groups. In both groups, most wounds that were treated did not close. For wounds that did close, the average time to closure was 2x faster in the BCMH group compared with the SOC group (7.4 weeks and 14.8 weeks, respectively; P < .05).

CONCLUSIONS: This retrospective evaluation showed average time to wound closure to be significantly faster with BCMH compared with SOC in patients who maintained adherence with regular visits.

PMID:36749996

Categories
Nevin Manimala Statistics

Assessment of an e-nose performance for the detection of COVID-19 specific biomarkers

J Breath Res. 2023 Feb 7. doi: 10.1088/1752-7163/acb9b2. Online ahead of print.

ABSTRACT

Early, rapid and non-invasive diagnosis of Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) infection is needed for the prevention and control of coronavirus disease 2019 (COVID-19). COVID-19 mainly affects the respiratory tract and lungs. Therefore, analysis of exhaled breath could be an alternative scalable method for reliable SARS-CoV-2 screening. In the current study, an experimental protocol using an electronic-nose (“e-nose”) for attempting to identify a specific respiratory imprint in COVID-19 patients was optimized. Thus the analytical performances of the Cyranose®, a commercial e-nose device, were characterized under various controlled conditions. In addition, the effect of various experimental conditions on its sensor array response was assessed, including relative humidity, sampling time and flow rate, aiming to select the optimal parameters. A statistical data analysis was applied to e-nose sensor response using common statistical analysis algorithms in an attempt to demonstrate the possibility to detect the presence of low concentrations of spiked acetone and nonanal in the breath samples of a healthy volunteer. Cyranose® reveals a possible detection of low concentrations of these two compounds, in particular of 25 ppm nonanal, a possible marker of SARS-CoV-2 in the breath.

PMID:36749983 | DOI:10.1088/1752-7163/acb9b2

Categories
Nevin Manimala Statistics

A Clinician’s Guide to Critically Appraising Randomized Controlled Trials in the Field of Speech-Language Pathology

Am J Speech Lang Pathol. 2023 Feb 7:1-15. doi: 10.1044/2022_AJSLP-22-00180. Online ahead of print.

ABSTRACT

PURPOSE: When considering original research articles, randomized controlled trials (RCTs) provide the highest level of research evidence. Given this, RCTS are often used by clinicians performing evidence-based practice to determine the most effective intervention for a specific patient or patient population. Although RCTs represent a high level of research evidence, it is important for clinicians to critically appraise RCTs to determine the validity of the study methods deployed, the statistical and clinical significance of treatment effects, and whether or not the results generalize to a particular patient, patient population, and/or clinical setting. Therefore, this tutorial will provide clinicians with an overview of what an RCT is, the various types of RCTs, when RCTs are appropriate to conduct and/or use to inform clinical practice, and the advantages and limitations of RCTs. Additionally, this tutorial will provide clinicians with practical tools to employ when reading an RCT, including checklists with questions, definitions of important terminology frequently used in RCTs, and demonstrations of how to critically appraise RCTs using literature examples from the speech-language pathology literature.

CONCLUSIONS: Learning how to interpret and apply the results from RCTs to inform clinical practice for purposes of improving patient care is a critical evidence-based practice skill for clinicians to develop. This tutorial will assist clinicians in the field of speech-language pathology by furthering their fundamental knowledge of RCTs and by providing them with pragmatic tools to critically appraise RCTs to inform their clinical practice.

PMID:36749981 | DOI:10.1044/2022_AJSLP-22-00180

Categories
Nevin Manimala Statistics

Effect of Repeated Multipatient Simulations on Professional Readiness Among Senior Nursing Students

Nurse Educ. 2023 Feb 6. doi: 10.1097/NNE.0000000000001373. Online ahead of print.

ABSTRACT

BACKGROUND: Senior nursing students are expected to be ready in terms of professional decisions and practices as soon as possible after graduation. Quality and Safety Education for Nurses (QSEN) is a framework to prepare nursing students for practice in the health care system.

PURPOSE: This study aimed to explore the effect of repeated exposure to multipatient simulations on senior nursing students’ pregraduation transition views, QSEN knowledge level and self-competency, professional readiness, and postgraduation transition shock.

METHODS: A randomized controlled trial of intervention and control groups with pretest, posttest, and a follow-up was conducted with 78 senior nursing students at a private, accredited, nursing program in Istanbul, Turkey.

RESULTS: There was a statistically significant improvement in the intervention group between the pretest and the posttest for self-confidence (P < .01), QSEN knowledge level (P < .01), and professional readiness (P < .01). The QSEN knowledge level (P < .01) and professional competency (P < .05) of the intervention group were higher than those of the control group.

CONCLUSION: These results suggest that multipatient simulations may be an effective strategy to better prepare students for the health care system’s demands.

PMID:36749954 | DOI:10.1097/NNE.0000000000001373

Categories
Nevin Manimala Statistics

Self-Assembly of Glycerol-Amphiphilic Janus Dendrimers Amplifies and Indicates Principles for the Selection of Stereochemistry by Biological Membranes

J Am Chem Soc. 2023 Feb 7. doi: 10.1021/jacs.3c00389. Online ahead of print.

ABSTRACT

The principles for the selection of the stereochemistry of phospholipids of biological membranes remain unclear and continue to be debated. Therefore, any new experiments on this topic may help progress in this field. To address this question, three libraries of constitutional isomeric glycerol-amphiphilic Janus dendrimers (JDs) with nonsymmetric homochiral, racemic, and symmetric achiral branching points were synthesized by an orthogonal-modular-convergent methodology. These JDs amplify self-assembly, and therefore, monodisperse vesicles known as dendrimersomes (DSs) with predictable dimensions programmed by JD concentration were assembled by rapid injection of their ethanol solution into water. DSs of homochiral JD enantiomers, racemic, including mixtures of different enantiomers, and achiral exhibited similar DS size-concentration dependence. However, the number of bilayers of DSs assembled from homochiral, achiral, and racemic JDs determined by cryo-TEM were different. Statistical analysis of the number of bilayers and coarse-grained molecular dynamics simulations demonstrated that homochiral JDs formed predominantly unilamellar DSs. Symmetric achiral JDs assembled only unilamellar DSs while racemic JDs favored multilamellar DSs. Since cell membranes are unilamellar, these results indicate a new rationale for nonsymmetric homochiral vs racemic selection. Simultaneously, these experiments imply that the symmetric achiral lipids forming more stable membrane, probably had been the preferable assemblies of prebiotic cell membranes.

PMID:36749951 | DOI:10.1021/jacs.3c00389

Categories
Nevin Manimala Statistics

Disaggregating the dementia monolith: An analysis of variation in Medicare costs and use by dementia subtype

Alzheimers Dement. 2023 Feb 7. doi: 10.1002/alz.12953. Online ahead of print.

ABSTRACT

IMPORTANCE: With an aging population, it is necessary to systematically examine variation in costs and use of Medicare services by dementia subtype. We provide the first national estimates for dementia by subtype, and the respective Medicare costs and use.

METHODS: We analyzed Medicare fee-for-service (FFS) claims from 2017 through 2019. The sample included 41 million beneficiaries: 727,700 beneficiaries with a new dementia diagnosis in 2017. We calculated descriptive statistics and conducted generalized linear regression models by subtype of dementia.

RESULTS: Annual Medicare costs for beneficiaries with dementia ranged from $22,840 for frontotemporal dementia to $44,896 for vascular dementia compared to $9,034 for beneficiaries without dementia. Comparing beneficiaries across dementia subtypes, the greatest differences were in the use of home health and hospice care.

CONCLUSIONS: These analyses demonstrate substantial heterogeneity across dementia subtypes, which will be important in developing models of care that improve value for people with dementia.

PMID:36749936 | DOI:10.1002/alz.12953

Categories
Nevin Manimala Statistics

What Factors are Associated With Conversion to Knee Arthroplasty After Subchondroplasty?

Clin Orthop Relat Res. 2023 Feb 7. doi: 10.1097/CORR.0000000000002557. Online ahead of print.

ABSTRACT

BACKGROUND: Subchondral bone marrow lesions identified on knee MRI are believed to play a role in osteoarthritis-associated pain. The subchondroplasty procedure is an arthroscopically assisted procedure for treating such lesions to avoid larger procedures such as knee arthroplasty. However, the survivorship free of conversion to arthroplasty and the factors associated with an increased likelihood of conversion of subchondroplasty to arthroplasty have not been well defined.

QUESTIONS/PURPOSES: We performed this study to (1) determine the 5-year survivorship of subchondroplasty free from conversion to knee arthroplasty (unicompartmental or total) and (2) identify variables that were associated with progression to knee arthroplasty after a subchondroplasty procedure.

METHODS: In all, 216 patients who underwent a subchondroplasty procedure performed by one surgeon with subchondroplasty experience at a single-center, multilocation facility between September 2014 and August 2017 were retrospectively evaluated to estimate survivorship free from conversion to knee arthroplasty at 5 years. The mean ± SD age and BMI at the time of subchondroplasty procedure were 59 ± 11 years and 33 ± 8 kg/m2, respectively; 60% (129 of 216) of the patients were women. Other variables collected were smoking status and grade and location of chondral lesions. The electronic medical record was reviewed to determine whether the patient had a knee arthroplasty after subchondroplasty. Survivorship free from conversion to knee arthroplasty at 5 years was calculated from a Kaplan-Meier survivorship estimator. Factors associated with progression to knee arthroplasty were examined using t-tests and chi-square analyses. Variables showing evidence of an association with knee arthroplasty were explored further using a Kaplan-Meier survivorship estimator (n = 190).

RESULTS: Kaplan-Meier survivorship free from conversion to knee arthroplasty was 73% (95% CI 67% to 79%) at 5 years after subchondroplasty. We found that age older than 50 years and Grade 4 chondral lesions were associated with conversion to knee arthroplasty. Patients with a Grade 4 chondral lesion had 5-year survivorship of 62% (95% CI 54% to 71%) and 59% (95% CI 50% to 69%) for those older than 50 years with a Grade 4 chondral lesion.

CONCLUSION: Currently, we recommend a detailed, informed discussion of the risks versus benefits with patients who are considering a subchondroplasty procedure, particularly patients aged 50 years and older and those with Grade 4 chondral lesions. Future randomized trials, including those that compare the subchondroplasty procedure with arthroscopy alone or nonoperative management options, are still needed to confirm the efficacy and role of the subchondroplasty procedure in patients with knee osteoarthritis, because only such prospective studies can determine the success of the procedure.

LEVEL OF EVIDENCE: Level IV, therapeutic study.

PMID:36749933 | DOI:10.1097/CORR.0000000000002557

Categories
Nevin Manimala Statistics

Module-Level Polaritonic Thermophotovoltaic Emitters via Hierarchical Sequential Learning

Nano Lett. 2023 Feb 7. doi: 10.1021/acs.nanolett.2c03476. Online ahead of print.

ABSTRACT

Thermophotovoltaic (TPV) generators provide continuous and high-efficiency power output by utilizing local thermal emitters to convert energy from various sources to thermal radiation matching the bandgaps of photovoltaic cells. Lack of effective guidelines for thermal emission control at high temperatures, poor thermal stability, and limited fabrication scalability are the three key challenges for the practical deployment of TPV devices. Here we develop a hierarchical sequential-learning optimization framework and experimentally realize a 6″ module-scale polaritonic thermal emitter with bandwidth-controlled thermal emission as well as excellent thermal stability at 1473 K. The 300 nm bandwidth thermal emission is realized by a complex photon polariton based on the superposition of Tamm plasmon polariton and surface plasmon polariton. We experimentally achieve a spectral efficiency of 65.6% (wavelength range of 0.4-8 μm) with statistical deviation less than 4% over the 6″ emitter, demonstrating industrial-level reliability for module-scale TPV applications.

PMID:36749930 | DOI:10.1021/acs.nanolett.2c03476

Categories
Nevin Manimala Statistics

UGH Syndrome Resolution after IOL Explantation and Concomitant Carlevale IOL Implantation

Ocul Immunol Inflamm. 2023 Feb 7:1-6. doi: 10.1080/09273948.2023.2169716. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine the use of Carlevale IOL placement in patients with UGH, and to evaluate surgical outcomes.

DESIGN: In this retrospective study, 28 patients with UGH syndrome that were subjected to IOL explantation and concomitant Carlevale IOL implantation were included in the study.

METHODS: Information about VA, IOP, number of glaucoma medication, need for glaucoma surgery, presence of hemorrhage and inflammation were recorded up to 6 months after the procedure.

RESULTS: We found a statistically significant increase in mean visual acuity and complete resolution of uveitis in all patients. Mean IOP and the mean number of glaucoma medications were significantly decreased postoperatively, while 14% of patients required additional glaucoma surgery.

CONCLUSIONS: IOL explantation and concomitant Carlevale IOL implantation may provide a viable solution for UGH syndrome resolution, increases visual acuity, and decreases the need for glaucoma medication.

PMID:36749924 | DOI:10.1080/09273948.2023.2169716

Categories
Nevin Manimala Statistics

Multivariate Tiered Approach To Highlight the Link between Large-Scale Integrated Pesticide Concentrations from Polar Organic Chemical Integrative Samplers and Watershed Land Uses

J Agric Food Chem. 2023 Feb 7. doi: 10.1021/acs.jafc.2c07157. Online ahead of print.

ABSTRACT

This paper presents a multi-step methodology to identify relationships between integrative pesticide quantifications and land uses on a given watershed of the Adour-Garonne Basin (Southwestern France). In fact, a large amount of pesticide concentration data was collected from 51 sites located in the Adour-Garonne Basin for a 1 year monitoring period in 2016. The sampling devices used here were polar organic chemical integrative samplers (POCIS), which provided time-weighted average concentration estimates. For each study site, its associated watershed and land cover distribution were determined using Corine Land Cover 2012 (CLC 2012) and Geographic Information System (GIS). The large-scale data were analyzed using multivariate statistical analyses, such as hierarchical cluster analysis (HCA) and principal component analysis (PCA). HCA grouped the 51 sites into five clusters with similar primary land uses. Next, the integrated pesticide concentration and land use distribution data sets were analyzed in a PCA. The key variables responsible for discriminating the sample sites showed distribution patterns consistent with specific land uses. To confirm these observations, pesticide fingerprints from sites with contrasting land uses were compared using a waffle method. The overall multivariate approach allowed for the identification of contamination sources related to their likely initial use, at the watershed level, that could be useful for preventing or containing pesticide pollution beyond simply acting on areas at risk.

PMID:36749916 | DOI:10.1021/acs.jafc.2c07157